DESCRIPTION: (Verbatim from the application) Stroke is the most common serious neurological disorder in the United States and its incidence doubles with each decade after the age of 55. Hemiplegia is a striking manifestation of stroke and contributes significantly to the physical disability and impaired quality of life of stroke survivors. The evolving scientific data suggest that active repetitive movement of the hemiparetic limb is effective in facilitating the motor recovery of stroke survivors. However, present rehabilitation strategies emphasize compensatory training of the unimpaired extremity to maximize function, and prevention of complications of immobility. The broad goal or this project is to develop strategies to facilitate the motor recovery of stroke survivors, and thereby maximize. their function and quality of life. Previous studies have suggested that repetitive exercises facilitated by electromyogram (EMG) controlled neuromuscular electrical stimulation (NMES) enhance the upper extremity motor recovery of stroke survivors. However, these early studies were poorly controlled, sample sizes were small, long-term follow up were absent and outcomes were limited to motor impairments only. The aim of this project is to assess the tong-term effect of EMG-controlled NMES on the motor impairment and physical disability of chronic stroke survivors. This study complements an approved project that investigates the short-term effect of EMG-controlled NMES on neurophysiologic measures of central motor function. A stratified randomized clinical trial design will be utilized. This study will demonstrate that EMG-controlled neuromuscular stimulation enhances the upper extremity motor and functional recovery of chronic stroke survivors. The proposed intervention may be effective for acute stroke survivors and for persons with other forms of central nervous system motor dysfunction such as traumatic brain injury, cerebral palsy, multiple sclerosis and incomplete spinal cord injury. EMG-controlled NIMES may also be effective for lower extremity motor and functional recovery.